Surgery for urinary incontinence

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1. Treatment of urinary incontinence


When a person leaks urine when sneezing, coughing or laughing, it means he suffers from urinary incontinence. If the symptoms cannot be controlled by non-invasive methods, should take into account surgery.

Currently, most surgery to treat urinary incontinence significantly increases the quality of patient’s life. Here are the details needed for anyone who is considering surgery to treat urinary incontinence.


Contents

1. Treatment of urinary incontinence
2. Success is variable
3. Injecting bulking agents
4. Urethral sling surgery
5. Complications
6. Measures to increase the chances of surgery success
7. Surgery can change a person’s life
8. Surgery is less used for urge incontinence
9. Treatment options for urge incontinence


2. Success is variable

Anyone suffering from urinary incontinence should consider whether his objectives can be achieved without surgery or not. No treatment offers the guarantee of success, but statistics have concluded that 85-90% of women who have undergone surgery for the treatment of urinary incontinence, defeated the disease.

However, including Kegel exercises may be an appropriate and non-invasive way to treat stress incontinence. If a person is willing to do these exercises several times a day, indefinitely, could be observed a 70% improvement in symptoms.


3. Injecting bulking agents

There are procedures that involve injecting bulking agents such as silicone around the urethra. These procedures may provide short-term relief of symptoms, but can be used by those who do not respond positively to surgery.

Injection is made repeatedly since the body will eliminate the injected substances after a certain period of time. The doctor may prescribe, if mild or moderate incontinence, including drugs to treat muscle spasms and antidepressants.


4. Urethral sling surgery

During this procedure the surgeon will insert a thin plastic strip that supports the bladder and urethra in a normal anatomic position. This will stop the uncontrolled leaking of urine when sneezing, coughing or laughing.

Suburethral mesh material used to treat the disorder is very important, because it can cause some infections (including urinary tract infections) and pain during intercourse. However specialists specify that the risk of complications is reduced, if we talk about urethral sling procedures, because they need relatively small piece of mesh and synthetic materials that have been associated with higher chances of developing infections have been withdrawn from the market.

Patient who will undergo surgery for urinary incontinence should seek an urologist surgeon. Before surgery the doctor must provide the patient details about complications associated with the procedure, but also about the treatment medical procedure to be instituted.

Urethral sling procedure may be ambulatory, without the patient to spend the night in hospital. In this case the patient will be locally anesthetized. Post-surgery pain will be relieved with some painkillers.

During the procedure, the doctor will insert a catheter, and, if the patient has difficulty urinating, he can keep the catheter in the first days after surgery. If there is discomfort when urinating may be necessary to readjust or even eliminate the sling.

After surgery, physical activity (including weight lifting, exercise) should be avoided, as the use of tampons or sexual intercourse for at least several weeks. If a week after surgery there are no leaks or pain, the doctor will allow the patient return to his normal activities.


5. Complications

As with any surgery, complications that can occur vary wildly, including bleeding, infection or damage to blood vessels or adjacent organs. However major complications such as significant bleeding or blood vessel damage occur only in about 1% of cases. In approximately 15-20% of cases it may be necessary to repeat the urethral sling surgery.


6. Measures to increase the chances of surgery success

There are a number of measures that could contribute to the success of the surgery. These include sufficient rest after the procedure, weight loss if the patient is overweight, avoiding smoking and Kegel exercises for pelvic muscles maintaining. Experts say that the chances for a second surgery to be needed are between 50 and 60%.


7. Surgery can change a person’s life

It is difficult for a person to cannot laugh or sneeze because some leakage of urine. Sling surgical procedure is easy and fast, and those who will benefit from this and will get positive results and can enjoy a normal life.


8. Surgery is less used for urge incontinence

Behavioral therapy, physical therapy and medication are still first choice for treating urinary incontinence, which is especially common in older people and involves frequent loss of urine without warning.

Medications for urge urinary incontinence (which may be caused by overactive bladder) acts by relaxing the body which is usually quite tense.


9. Treatment options for urge incontinence

The most common surgical option for severe urge incontinence is augmentation surgery that involves expanding bladder so it can hold a larger amount of urine.

Another alternative would be neuromodulation, which involves implanting a wire in the sacrum, at the base of the spine that sends electrical impulses to the nerves that control the bladder, thus contributing to relaxation.

If treatment relieves symptoms by at least 50%, the patient could be eligible for implantation of stimulators. Also, the researchers currently study the effect Botox injection preparations in order to relax the bladder.

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